Compelling commentary on children's health

In the category of on-the-edge child rearing trends comes diaper free parenting. I thought this died a quick death after its 5 minutes of fame on the front page of the Sunday New York Times some months back. Apparently not.

Proponents of the diaper free movement advocate elimination communication (EC), or close attention to a baby’s cues of impending elimination. Babies are positioned and then coaxed with the enticing sounds of nature. You can read a first hand account of one diaper free Dominic on MSNBC. I can only describe the story as gripping.

As a pediatric gastroenterologist I have to ask why.

While babies are capable of primitive conditioning, EC remains nothing other than this. True control of elimination can occur only after a child’s first birthday – for many it’s closer to the second birthday. It’s at this time that the association of rectal fullness can be associated with impending elimination. And it’s only at this time that volitional control of the external sphincter can be exercised with the intent to hold onto their business.

While these Pavlovian pranks make fodder for the media, I’m not impressed. I’m tempted to think that diaper free parenting, like so many child rearing fads, may be more about mom than baby.

It seems that picky eating could be in the genes. A new study published in the American Journal of Clinical Nutrition has found that some 80% of children’s tendency to avoid new foods was inherited. The researchers studied 5,390 twins between the ages of 8 and 11 years old. This type of study allows the separation of environmental and genetic factors that could be contributing to a problem.

While we always have to interpret clinical studies with caution, it seems that children are who they are when it comes to eating. Those of us with more than one child or experience with lots of children know this to be the case. But eating isn’t all about the genes. Feeding environment, presentation and the feeding relationship you share with your child are all variables that will help shape healthy, well-adjusted eaters.

Distance and space from your child is perhaps one of the greatest ways to facilitate a healthy feeding relationship. When it comes to feeding, children should never be pushed. Pressure feeding and coercion nearly always leads to further anxiety with feeding. This goes for “healthy eaters” who may not be in the mood when the dinner bell strikes as well as food neophobic children who are more apt to do things on their own terms.

And always remember Ellyn Satter’s division of responsibility which tells us that it’s our job to prepare the food and our kid’s job to eat it. And the two shall never cross. Timely advice given this new research.

I’ve always said that presentation is critical when it comes to children accepting food. Now there’s proof.

According to a recently published Stanford study, everything tastes better in a McDonald’s wrapper. The study published in this month’s Archives of Pediatrics and Adolescent Medicine looked at the preferences of a group of 3 to 5 year olds presented with a variety of foods. As it turns out kids preferred whatever was in a McDonald’s wrapper.

While it should come as no surprise, the study shows us that kids are remarkably susceptible to branding (or at least super savory food) at a young age.

But the media is befuddled. How could McDonald’s brainwash our children? The talking heads have chimed in and everyone wants answers. But it’s just another case of Flying Twinkies. Kids don’t drive themselves to McDonalds and they only know we feed them. So much as we’d like to blame someone other than ourselves for the habits that we instill in our children, we’re ultimately responsible for the choices we make.

True confessions: while my kids live in a well-balanced household that isn’t ashamed to admit to occasional fast-food use, they would have tested just like the subjects in this study.

A study just published in the Journal of Pediatrics has concluded that listening to baby genius videos may actually do little to create geniuses - In fact, early viewing of videos may be associated with poor language development. Is this a revelation? No, claims Julie Aigner-Clark, the founder of Baby Einstein. She has suggested that her product was designed to make babies happier, not smarter.

Perhaps the revelation is that evidence based studies can actually disprove the veiled claims of market-driven products. As a pediatrician and a father I’m always quietly suspicious of parents who work seek to create their version of a child prodigy. And it’s inconceivable that such a thing could be achieved by placing a child in front of a television screen.

So is this the beginning of the end of a lucrative cottage industry? I doubt it. So long as there’s the suggestion of a magic bullet that may put a child closer to the front of the line, there will always be a market.

You know its time for back-to-school when ads start appearing for bulletproof backpacks.

As reported by the Boston Herald, two dads from Danvers, Massachusetts have developed mercenary-style book bags that apparently ward off stray bullets, knives and misguided machetes. The secret ingredient seems to be a lightweight bulletproof plate that lines the inside of the pack. Skeptical parents should be assured that the packs meet the National Institute of Justice standards for safety

David Roylance, associate professor of material science and engineering at MIT, seems to think that a big textbook might do just as well. But then again, you can’t be too safe.

This is interesting: According to a study just published, preschoolers consume 30% more food when eating in large groups compared to small groups. Kids between the ages of two and six were studied when eating in groups of three and nine. The researchers found that group size and snack duration were significant and independent predictors of the amount that children will eat.

This is a phenomenon referred to as social facilitation and it’s seen in adults. Studies have demonstrated that adults eat 30% to 50% more when eating in groups compared to eating alone.

Can we extrapolate this for picky eaters? Probably. Children with other issues such as oral sensory aversion (gagging with complex textures) will often overcome their aversion in social feeding circumstances. In other words, children with feeding disorders can, in some cases, overcome their difficulties among their peers. This is probably more powerful once children hit four or five year of age, or once the biological drive to eat becomes mediated by social and environmental forces.

This is interesting given the recent New England Journal of Medicinearticle on social networks and obesity. Essentially, our friends and the company we keep may help determine the way we eat and the way we look. And kids seem to be no different.

For months my neighbors and I have struggled with speeding cars in our neighborhood. We’ve tried orange cones, yellow “children at play” standing signs and even old-fashioned hot pursuit of perpetrators. Nothing seems to have done the trick.

I may have found my answer.

One Mike Wood of Ohio has created life-sized stand up photographs of his kids. These cut outs are perched by the road in front of his house and they’ve cut into the number of self-serving speeders in his neighborhood. Some have even criticized him for letting his “kids” wander so close to the street. Apparently his faux toddlers are for sale at $60 but I can’t find a link.